Lisa tells us that she was told by an expert OT:
<Among other concepts I "got" for the first time was that rigid bottle
systems
offer resistance to flow, while bag systems offer no resistance at all
and allow milk to pour out fast.>
That seems to me like quite a generalization. Certain things I remember
from teaching baby care classes upwards of 3-4 decades ago, and have
noted with my own kids and grandkids. Many people don't realize that the
temperature of the liquid makes a big difference in flow rate of the
liquid. The warmer it is, the faster it seems to come out of the nipple.
Most people still feel insensitive in giving a baby refrigerator
temperature milk, harmless as it's supposed to be. So most choose to take
the chill off of it, and in doing so, many get it quite warm.
Unfortunately there are still those that use the microwave, unaware of
the danger of hot spots in the liquid that can scald the baby's mouth and
throat (as well as destroy componenets in EBM).
"Rigid" bottles really do have a mechanism for preventing the build-up of
vacuum as milk is removed from the bottle. In the rubber collar of the
nipple there are two holes, that may need to be cleaned with a toothpick.
As the rubber nipple fits into the plastic collar which is screwed on the
bottle, if that plastic collar is screwed on too tight, the air cannot
enter through the rubber collar holes, and a vacuum builds up, causing
flow to get very slow and require a lot of suction labor from the baby,
until or unless the baby lets go and a stream of bubbles can enter
through the hole in the tip of the nipple.
(Sometimes I wonder whether that might be used to a certain advantage,
deliberately tightening it very tight, to slow the flow and require the
baby to suck hard and take breathing breaks. But then again, not good for
swallowing habits or dental arches in the long run. I favor Dee Kassing's
suggestions when a bottle is chosen as an intervention.)
As for the bag systems, my understanding is that they keep any such
vacuum from building up inside by collapsing from the weight of natural
external air pressure as the baby removes milk. (Of course the
advertising hype is always that because air is removed from the bag at
the beginning, the baby can't swallow any air!!!) I don't think the bag
systems lead to any more rapid flow rate necessarily, depending on the
size of the nipple hole and the temperature of the milk. The adult can
also put external pressure (sort of like breast compression???) on the
bag if desired to speed up the milk flow a little. There are now many
various shapes of nipples available to go on various brands of bag
systems as well as rigid bottle systems. This gives more of a choice to
obtain one with a base that can be used to maintain the flanged open
position of the baby's lips rather than the "kissy prissy" straw-sucking
grasp just on the smaller end of the nipple.
I believe it helps my skill in teaching parents to stop now and then at
these counters in the grocery and the discount stores just to see what
new hype and type has been dreamed up by what company. There is so much
conflicting info out there to mess up a new parent! But I notice a lot of
manufacturers are slyly, and not so slyly, adopting language like
"latching" on their labels, to take advantage of parents who might assume
those items are more "friendly to breastfeeding" simply because the
manufacturers too are being very careful how they say things!
Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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